A kinder SSDI application process for seriously ill claimants

Aug 20 2015

The Compassionate Allowance program fast tracks Social Security Disability Insurance applications for the sickest claimants.

It is well known that it can take the Social Security Administration months or even years to correctly process a Social Security Disability Insurance application to the point of actually finding that a claimant meets the definition of disability and awarding benefits. In response to criticism, the SSA created the Compassionate Allowances program as one of its initiatives to more quickly get financial relief to people whose disabilities are not going to be hard to prove.

SSDI is the federal disability insurance program of the SSA. Many people do not know they are also paying for disability insurance coverage when they make Social Security payroll deduction contributions to the SSA. When a financially qualified individual (one who worked recently enough and enough over the years to meet eligibility requirements) becomes disabled and cannot work, SSDI provides monthly money benefits.

The definition of disability for SSDI is specific: to be disabled, the claimant must have a serious physical or mental medical impairment (or combination of impairments) expected to last at least a year or result in death that prevents him or her from working.

To answer the question of whether someone is disabled, the agency uses a five-step process, into which is incorporated a thorough review of objective medical evidence. Adding to the delay in processing is the fact that initial applications are often denied, requiring deserving claimants to request review and appeal in order to get to a higher level within the agency or in federal court where their valid applications are finally correctly decided.

Compassionate Allowances or CAL is a way to cut through all of these procedural roadblocks by flagging initial applications based on certain devastating medical diagnoses that are so highly likely to create disability that quick approval is warranted based on objective medical evidence of the diagnoses. CAL impairments number more than 200 as of this writing.

CAL is not a different program, but rather an attempt to identify such conditions immediately and fast track the SSDI approval process.

According to the SSA website, a CAL decision may take “weeks instead of months or years.” Since CAL conditions are especially severe, the financial relief cannot come too soon in most cases.

To identify medical diagnoses appropriate for CAL designation, the SSA consults with a wide community of medical experts, governmental agencies, advocacy groups and more, including attendees at a series of public hearings on various kinds of impairments conducted since 2007. SSA intends to continue to add new diseases yearly to the CAL list.

Hearings so far have focused on autoimmune diseases, cardiovascular diseases and multiple organ transplants, schizophrenia, early onset Alzheimer’s disease, brain injury and stroke, cancers and rare diseases. The CAL conditions list reflects mainly these kinds of diseases and conditions.

Whether suffering from a CAL condition or any other disability, anyone facing the SSDI application process initially or during processing who has not consulted with an experienced SSDI attorney should seek out legal advice and representation. Despite it being a public benefit many Americans have earned through payroll deductions, establishing eligibility can be extremely challenging as the legal issues and procedural requirements can be complex and burdensome. Involving a lawyer at any stage can be extremely helpful.

In Denver, SSDI attorneys at Alverson + O’Brien, P.C., advocate for clients seeking SSDI benefits.